オトガイ部の知覚鈍麻を初発症状とした多発性骨髄腫の１例

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Multiple myeloma is a malignant neoplasm that is characterized by a monoclonal proliferation of plasma cells. Oral maxillofacial manifestations as an initial symptom of multiple myeloma are rare. We report a case of multiple myeloma with initial symptoms of paresthesia of the mental region. A 78-year-old female visited to our hospital with chief complaints of paresthesia of the right mental region. The mucosal surface of the right lower molars was normal. Unclear bone resorption in right mandible was found on the panoramic radiograph. Contrast-enhanced CT and MRI showed soft tissue lesion contrasted uniformly in right mandible bone marrow. PET-CT revealed abnormal uptake in the right mandible （SUVmax: 8.8）, the manubrium of sternum （SUVmax: 5.8）, the left thighbone （SUVmax: 6.0） etc. After physical examination and imaging, laboratory investigations and biopsy were conducted, confirming the diagnosis of multiple myeloma （IgA-κ）. In the department of hematology, chemotherapy, VMP （bortezomib, melphalan, predonisolone） and BD （bortezomib, dexamethasone）, was administered. After chemotherapy, the tumor didn’t regrowth and the symptom of paresthesia was slightly improved.

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